Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03759 | Date 21/02/2019 |
| Token No | SM/18-19/9583 28/02/2019 | Serial | 005 Last Visit: 26/08/2019 |
| Patient Name | Mr. NANI LAL GHUCHAIT | Contact No | 9804672309 |
| Address | 39 CHATRA SACHTASI PARA, BAIDYABATI (M) | Age | 57 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||